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In today’s competitive work environment, many employees are reluctant to admit to having difficulty handling stress in the workplace; even fewer are comfortable discussing their mental health or substance abuse histories with their employers.
Nevertheless, these issues have a much greater impact on the workplace than most people realize. Since one in five people in BC has or will develop a mental disorder, most offices and job sites have at least one person with a history of major depression, an eating disorder, schizophrenia, an anxiety disorder, addiction or some other mental health problem.
However, because of the stigma attached to mental illness and addictions, employees often blame themselves and remain silent when they become depressed or are unable to meet employers’ rising expectations because of a mental health problem.
Michael Koo, 34, says he was devastated when his coworkers complained in a performance evaluation that he wasn’t pulling his weight. But Koo says he didn’t feel comfortable explaining that a major depression was the reason for his low productivity. “My thought was, ‘I can’t afford to let them know what was going on, ‘cause I’ll lose my work,’” he recalls, adding that stress leaves were associated with shame.
Jane, a 30-year-old biologist, says she never discussed her clinical depression with her employer because she was afraid of losing respect. “People in the workplace want to be dealing with consistent and reliable colleagues,” she says, “Being perceived as being vulnerable to depression limits how much people feel they can invest in you.” Although she hid her depression, Jane says she lost all credibility with her company when her work began to suffer. “I would fall short on my commitments and was unable to justify my inability to produce according to expectations,” she explains.
In some cases, the fear of losing one’s job and the respect of one’s colleagues is enough to prevent people from seeking treatment. Physicians, for example, often deny their own mental health needs and hide their conditions to protect their careers. A study of medical students revealed that concerns about confidentiality, stigma, documentation on academic record, and forced treatment were concerns among the top barriers to mental health care for those in the medical community. As a result, the rate of completed suicides among physicians is much higher than in the general population.
Hidden or not, untreated mental illness and job-related stress are having a huge impact on Canadian workplaces. Work-related pressures—such as long commutes, the rapid pace of technological change and the threat of job loss in an unpredictable economy—are contributing to higher levels of depression, anxiety and burnout among people between the ages of 25 and 54, a population making up 70 per cent of the workforce. A 2004 Ipsos Canada survey found that stress is the second highest contributor to absenteeism and health costs in the workplace—with depression, anxiety, and other mental health disorders at the top. ‘Presenteeism,’ or lost productivity while at work, is also a major issue for employees with depression and anxiety disorders, according to a 2006 Canadian review.
Stress in the workplace is a major cause of clinical depression among adults in their prime working years, the people who drive Canada’s economy. In a 2002 Statistics Canada study, it was found that over a quarter of British Columbians rated most days at work to be quite a bit or extremely stressful. Statistics Canada also found that the employee absenteeism rate jumped from 7.3 workdays in 1997 to more than 9 workdays in 2004—for reasons of illness, disability, or other personal and family demands.
Stress isn’t just evident in those absent from the office, either. Nearly 12% of Canadians work more than 50 hours per week. And nearly a quarter of Canadians work paid or unpaid overtime, according to Statistics Canada—an average of 8.5 extra hours per week. According to Ipsos Canada, an average of two vacation days per employee go unused—and 10% don’t take any vacation days at all.
As a result, disability claims for stress and depression are skyrocketing. According to Watson Wyatt, a firm that audits disability claims, psychological conditions like stress, anxiety, and depression are the leading causes of both short term and long term disability costs. A report from the Global Business and Economic Roundtable on Addictions and Mental Health notes that up to 12% of a typical company’s payroll is lost to disability. “Unchecked mental health disorders, especially depression, are driving business costs up through accelerated disability and absenteeism,” the report’s authors caution.
Watson-Wyatt’s 2005 report found that nearly three-quarters of the organizations studied cited stress as an issue affecting employee productivity. Nearly one in four workers receiving a federal public disability pension has a mental disorder. A Canadian study released in 2006 by Desjardins Financial Security found that about one in five workers had physical health problems stemming from mental health issues. Nearly two-thirds of this group kept regular work schedules instead of taking time off to recover.
Problem substance use also has a significant impact on organizational effectiveness. Only a small percentage of people with substance use problems are among the visible and highly marginalized populations such as those on Vancouver’s downtown eastside. The rest are active in the community, and are often employed. However their substance use problems may reduce their efficiency at work, and cause them to take frequent sick leave. Additionally, drug and alcohol use and other addictive behaviours (such as gambling) are usually associated with other social, family, legal, and mental health problems, which also impact workplace performance.
Nevertheless, many employers and organizations are slow to recognize the impact of mental health and substance abuse problems on the workplace.
For example, even though employee illness and disability costs Canadian workplaces an estimated $16 billion annually, and mental health concerns lead the pack, WorkSafe BC does not recognize psychological disabilities such as clinical depression, addictions and anxiety disorders as occupational diseases, nor does it list them in its schedules for determining awards.
Employers often expect workers to be immune to stress and are reluctant to hire people with known mental health problems. But having a mental illness doesn’t necessarily prevent a person from contributing as a valuable employee. In fact, companies that accommodate a worker with a history of mental illness often benefit from that person’s unique talents.
For example, people with bipolar disorder (manic depression) are often highly entrepreneurial, creative and skilled at accomplishing many tasks simultaneously. The flip side of this illness is severe depression. But once they receive proper treatment, most people with bipolar disorder can return to work and continue to function as highly effective employees. The main reason these employees succeed is the presence of social support to help with the practical needs of day-to-day life.
Workers with histories of mental illness or addictions are often better at pacing themselves than their highly-stressed counterparts, since they understand the importance of maintaining an even keel to prevent a relapse.
Maurizio Baldini, a mental health advocate and former lawyer, says self-awareness, regular exercise and proper nutrition have contributed to his 13-year respite from schizophrenia. “Even the stress of a full-time job doesn’t affect my mental health if I maintain a balanced life,” Baldini says.
Although many organizations mention people as their biggest asset, less than a third of the organizations surveyed by Watson Wyatt indicated they planned to implement programs dealing with mental health over the next few years. And only 5% had plans to deal with the stigma surrounding mental illness.
However, stress prevention is good business, according to Danielle Pratt, president of Workplace Health Promotion Inc., a Vancouver-based consulting firm. Companies that create supportive workplaces increase productivity and save on costs related to absenteeism, WorkSafe BC costs and job turnover. Supportive workplaces can also improve employee relations and morale and allow workers to focus on the needs of clients, she adds.
Pratt mentions National Rubber as an example. In the early 1990s, the company was hit with a $500,000 fine from the Worker’s Compensation Board because of its high accident rate. By adopting an attitude that all workplace injuries could be prevented and by involving employees closely in the process, the company was able to turn around a stressful workplace, disastrous safety record and a failing business. As a result, for two successive years, the company received $300,000 back from the WCB.
Investing in strategies to reduce stress and support mental health needs in the workplace is a win-win situation for workers and employers—with or without an active mental illness.
Mental Illness and WorkSafe BC
WorkSafe BC does not recognize psychological disabilities such as clinical depression, substance abuse and anxiety disorders as occupational diseases, nor does it list them in its schedules for determining awards
long-term disability claims for psychological illness alone are extremely rare; such cases fall under non-scheduled awards, which are based on whether the disability is deemed to prevent the employee from returning to work
most long-term disability claims for psychological illnesses are for post-traumatic stress disorder, which involves a sense of re-experiencing a traumatic event for months and sometimes years after the incident
claims for post-traumatic stress disorder must be linked to a specific incident, for example, a police officer who has shot an individual during the course of duty and is unable to return to work because of ongoing emotional trauma
between 1980 and 2004, claims for traumatic stress in the workplace have risen exponentially. While there were fewer than 1000 claims between 1980 and 1994, there were double that number in just the five years of 2000-2004
days lost to traumatic stress from 1980-2004 total nearly 410,000 days at a cost of $61.5 million
of all occupational diseases recognized by WorkSafe, psychological injury ranked only behind repetitive motion injuries (such as tendinitis, bursitis or carpel tunnel syndrome)
Source: Worksafe BC
Signs an Employee may be Experiencing Depression
an increasing difficulty making decisions
a decrease in productivity
an inability to concentrate
a decline in dependability
an unusual increase in errors in work
proneness to accidents
frequent lateness and increased “sick” days
an uncharacteristic lack of enthusiasm for work
personality or behavioural changes that appear “out of character” for the person
Keep in mind that people with depression will try hard to mask their illness because of fear of being reprimanded, dismissed or stigmatized for feeling down.
What Co-Workers Can Do to Help
If a co-worker shows signs of clinical depression:
continue to show them respect
help make the person aware of their value in the workplace and to their colleagues
offer encouragement and pay genuine compliments
remind yourself and your co-workers that 80% of people with depression can recover if they get help
use the trust between you to encourage the person to speak to their health care professional or your employee assistance professional who can direct the person to appropriate treatment
Ways Employers Can Help Reduce Workplace Stress
learn what causes workplace stress
provide positive feedback and engage in two-way communication with employees
offer flexible hours for juggling family responsibilities
provide employee assistance programs to help people get counseling on personal, financial or other problems
provide or help with the cost of stress control programs
offer on-site fitness facilities and access to nutritious food
create an environment that offers fresh air, proper lighting, regular work breaks, and reduced noise
permit someone recovering form a mental illness to work fewer hours rather than totally disconnecting them from the workplace
The Evolution of Work-Life Imbalance
The average work week has increased from 42 to 45 hours per week over the past decade.
40% of employees work more than 50 hours per week, compared to 25% in 1990.
Canadians spend only about 17 hours a week in non-work-related activities.
52% of employees take work home with them, up from 31% in 1990.
18% of employees now take unpaid ‘catch-up’ work home with them.
59% of employees check their voicemail after hours, 30% accept work-related faxes at home, and 29% keep their cellphones on.
81% of white-collar employees accept business calls after hours; 65% check their email from home. 46% consider this work-related contact to be an intrusion on their lives.
44% of Canadians working for large companies report negative spillover from work to family.
An estimated 28% of working Canadians feel that family and friends resent the number of hours they spend working.
Source: Warren Sheppell
Sources
Canadian Psychiatric Association. (2001). Clinical guidelines for the treatment of depressive disorders. Canadian Journal of Psychiatry, 46(Suppl 1).
Desjardins Financial Security. (2006, June 1). Concerns over money squeeze the zest out of life for Canadian workers. www.dsf-dfs.com/en-CA/NtrCmpgn/SllPrss/SllPrss
Hampton, T. (2005). Experts address risk of physician suicide. Journal of the American Medical Association, 294(10), 1189-1191.
Ipsos Canada. (2006). The 2006 Expedia vacation deprivation survey. Toronto. www.ipsos-na.com/news/pressrelease.cfm?id=3083
Ipsos Canada. (2004). Contributors to workplace absenteeism and healthcare benefit costs. Toronto. www.ipsos-na.com/news/pressrelease.cfm?id=2089
Pratt, D. (1996). Family-friendly workplaces. [A workshop for the Canadian Pension and Benefits Institute 1996 Conference.]
Statistics Canada. (2004). The Canadian labour market at a glance, 2003. Labour Statistics Division: Catalogue no. 71-222. www.statcan.ca/english/freepub/71-222-XIE/71-222-XIE2004000.pdf
Sanderson, K & Andrews, G. (2006). Common mental disorders in the workforce: Recent findings from descriptive and social epidemiology. Canadian Journal of Psychiatry, 51(2), 63-75.
Statistics Canada. (2002). Self-rated work stress, by sex, household population aged 15 to 75 inclusively, Canada and provinces, 2002. CANSIM table 01051100. Canadian Community Health Survey, Mental Health and Well-being. cansim2.statcan.ca/cgi-win/cnsmcgi.exe?Lang=E&RootDir=CII/&ResultTemplate=CII/CII___
&Array_Pick=1&ArrayId=1051100
Statistics Canada. (2004, November 10). Bipolar 1 disorder, social support and work. The Daily. www.statcan.ca/Daily/English/041110/d041110b.htm
Statistics Canada. (2005). Fact sheet on work absences. Perspectives on Labour and Income, 6(4), 21-30. www.statcan.ca/english/freepub/75-001-XIE/comm/2005_03.pdf
Warren Sheppell. (2004). Work-life issues: An EAP’s perspective. www.warrenshepell.com/research/latest.asp
Watson Wyatt Worldwide. (2005). Rising mental health claims top list of concerns in 2005 Watson Wyatt Staying@Work survey. www.watsonwyatt.com/news/press.asp?ID=15216
Wilson, M., Joffe, R. & Wilkerson, B. (2002). The unheralded business crisis in Canada: Depression at work. Toronto: Global Business and Economic Roundtable on Addictions and Mental Health. www.mentalhealthroundtable.ca/aug_round_pdfs/Roundtable%20report_Jul20.pdf
WorkSafe BC. Table 1: Occupational disease claims by type of disease and five-year period, 1980-2004. www.worksafebc.com/publications/reports/statistics_reports/
occupational_disease/pub_10_20_50.asp
Links in the Sources section are up to date as of June 2006
